Provider Alert! Adoption Assistance

Subject: Adoption Assistance
Attention all Texas Children’s Health Plan providers:

Effective 09/01/2017 Adoption Assistance members are required to enroll in managed Medicaid and will be new members with Texas Children’s Health Plan STAR or STAR Kids programs. For Continuity of Care, Texas Children’s Health Plan will receive authorizations from TMHP for Adoption Assistance services on Texas Children’s Health Plan members, effective September 1, 2017. Texas Children’s Health Plan will honor all existing authorizations until expiration or end of 90 days after transition, whichever comes first. Providers should provide services as authorized under TMHP.

If you do not have authorization for services from TMHP and TCHP requires an authorization for this service, you will be required to have these services authorized.

Upon expiration of existing authorizations, providers will need to follow the Texas Children’s Health Plan authorization policies and guidelines.

Durable medical equipment and disposable supplies, not on the TCHP authorization list, are paid up to the limits set by Texas Medicaid without an authorization. Requests for supplies over the monthly limits will require documentation of medical necessity and approval by TCHP..

Please do not fax or send additional requests to Texas Children’s Health Plan if you have already received a TMHP authorization. Duplicate requests may result in delayed payments.

If you have any questions on how to bill Texas Children’s Health Plan, the authorization requirements, or any other questions, please contact Texas Children’s Health Plan Provider Relations at 1-800-731-8527, or visit our website at http://www.texaschildrenshealthplan.org/forproviders/provider-resources

Please utilize the Utilization Management Authorization fax line for the following services:

Medical Services
832-825-8760 or Toll Free 844-473-6860

Behavioral Health Services
832-825-8767 or Toll Free 844-291-7505

Long Term Services and Support Services
346-232-4757